Portal venous gas following chemotherapy for colorectal cancer liver metastasis.
The standard of care for patients with colorectal liver metastases is a combination of chemotherapy and surgery. New chemotherapy regimens with biologic agents (cetuximab, bevacizumab) have been shown to increase tumor response rates. Although this might be beneficial and this is an expected endpoint, it should be noted that patients with synchronous colorectal and liver metastases are at risk of septic complications. We recently encountered a case of hepatic portal venous gas after two cycles of chemotherapy in a patient with right colon cancer liver metastases. Complete necrosis of the liver metastasis subsequently turned into a liver abscess, which fistulized in the right portal vein. Infection of the necrotized metastasis was thought to be promoted by the colic tumor. Although this is a dramatic situation, it does not contraindicate a curative surgical resection.
Zalinski
S
S
Department of Hepatobiliary Surgery and Liver Transplantation, Cochin Hospital, Paris, France.
Scatton
O
O
Jacqmin
S
S
Tacher
V
V
Brézault
C
C
Soubrane
O
O
D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D005740:Gases; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D011169:Portal Vein; D014057:Tomography, X-Ray Computed
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D005740:Gases; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068818:Cetuximab